Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
BACKGROUND OF THE INVENTION
A. Field of the Invention
This invention relates to surgical apparatus, and more parti-
cularly to retractors.
B. Background of the Invention
During the course of a surgical procedure, the wound is
separated and retracted by means of retractors or stay sutures,
which are generally held by trained assistants. Current retractors
retract the wound in a non-yielding manner such that manipulation
and movement by the surgeon as well as movement caused by con-
tracting muscles or tissues of the patient result in bruising or
tearing of the tissues. Once the wound is separated and retracted,
further stabilizing, retracting, or delivering of exposed tissues
or organs, require the placement of additional retractors or stay
sutures which, again, must generally be held by trained assistants.
Some organs are sufficiently mobile, for example, the eye, kidney,
or bladder, that there are no retractors which fit the organ
without the distortion thereof. Such organs require multiple
stay sutures, which require excessive time and expense in the
repeated placement, retraction, fixation, holding and often
untangling of the stays.
SUMMARY OF THE INVEMTION
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It is an object of the present invention to provide a retractor
which overcomes the shortcomings of the prior art. ~ore ~specifically,
it is an object of the present invention to provide a retractor
that decreases or eliminates the
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need for trained people to retract tissue at the direction of the surgeon It is a
further object of the present invention to provide a retractor that allows the
surgeon to quickly and repeatedly adjust the retraction, delivery, fixation, and
exposure of various parts of the wound and its contents as the operation
progresses.
Briefly stated, the foregoing and other objects of the present
invention are achieved by providing a retractor that includes a generally annular
frame conformed to fit the surface contour of the portion of the body to be
operated upon. A plurality of stays are provided, which are adapted to be
inserte~l into and held ;n~place in a plurality of notches spaced about the
periphery of the frame. The stays include a tissue holding device, for example, a
hookt and an elastic member. The surgeon can adjust quite precisely the traction
applied to the tissue by the placement of the elastic member within the slots.
`Also, the surgeon can quckly readjust both the direction and force of the
traction quickly and easil-g;
BRIEF DESCRIPTI~3~ OY-T~IE DRAWINGS
Fig. 1 is a top view of one preferred embodiment Oe the present
invention, which ill~strqtes a retractor adapted for use in the genitourinary area.
.
Fig. 2 is ~ side-view of the retractor of Fig. 1.
- Fig. 3 is ~ side view of the stay of the present invention.
Fig. 4 is a Yie~-showing the retractor of Fig. 1 in use in performing a
bladder operation~
Fig. 5 is a v~w of another embodiment of the present invention in use
to perform a kidney oper~tion.
DESCRIPTION OF TH33 PRE~ERRED EM330DIMENT
Referring now to the drawings, the retractor of the present invention
is designated generalls~r by the numeral 11. Retractor 11 includes a generally
annular frame 12 and a plurality of stays, each designated generally by the
numeral 2û. -
Referring to ~ig. 3, each stay 20 includes an elastic member 21 thatis connected to a tissue-holding device, which in the preferred ernbodiment is a
hook 22. In the preferred embodiment, elastic member 21 comprises a section of
silicon rubber tubing. Hook 22 includes a shank portion 23 and a recurved handle
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portion 24. In the rnanufacture of stay 20, an end of elastic member 21 is soaked
in ~ylene until the end becomes malleable, whereupon handle portion 24 is
inserted thereinto. When the xylene evaporates from elastic member 21, the
tubing again becomes elastic and holds handle portion 24 firmly in place. The
shape of handle portion 24 provides a convenient means by which the surgeon can
manipulate hook 22.
Referring now to Figs. 1 and 2, frame 12 is formed from a non-
yielding material, as for example stainless steel, and is conformed to fit the
surface contours of the portion of the body to be operated upon, as for example
the genitourinary area as sha-.vn in Fig. 4. ~rame 12 has a plurality of notches 13
about the periphery thereof. The width and depth of each notch 13 is such that
elastic portion 21 of stay 2û may be inserted therein and held in place by friction
without damaging elastic member 21. Frame 12 includes a spacer portion 14
around th~ lower side thereof, which spaces notches 13 from the body to allow
the surgeon easier access thereto.
A portion~ designated by the numeral 15, is hingedly connected to
frame 12 so that the shape o frame 12 may be chan~ed, as shown in Fig. 2.
Portion 15 may be lowersd to the position designated by the numeral 18 in Fig. 2
when retractor- 11 is iused as illustrated in ~ig. 4. Portion 15 may bQ raised to the
position designated by the numeral 17 in Fig. 2 when retractor 11 is used in the
scrotal approach te~hnique in implantation of a penile prosthesis.
The operation of the retractor of the present invention may be
understood by referringr to Figs. 4 and 5. Fig. 4 illustrates the use of retractor 11
to expose the bladder 33. The surgeon would first place frame 12 as shown.
After making his initia~ ineision, the surgeon would use a pair of stays 20 to open
the wound designatsd generally by the numeral 31. The surgeon can control the
tension applied to the edges of the wound by his placement of stays 20 in
notches 13. As the surgeon proceeds through deeper layers of tissue, wound 31 is
pulled further open by the tension of elastic members 21, and if the direction or
force or direction of the tension that is necessary needs to be changed, the
surgeon can quickly do so simply by removing and reinserting hook 22 and~or by
moving elastic member 21 to a difIerent notch.
A further example of the use of the retractor of the present invention
is shown in Fig. 5, which illustrates a kidney operation. A frame 40 is provided
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to conform to the right flank. Again, a plurality of stays 20 would be used to
open the wound and thereby expose the kidney 50. Fi~. 5 illustrates further the
versatility of the retractor of the present invention. ~or e~cample, a section of
tubing, designated by the numeral 25, may be looped under the kidney to susper.d
and to deliver the kidney to the surgeon for greater ease in operating thereon.
.~dditionally, another section of tubing, designated by the r.umeral 25, could be
used as a tourniquet to halt the flow of blood to the kidney.
From the foregoing, it can be seen that the retractor of the present
invention increases greatly the efficiency and effectiveness of the surgeon. At
least one member of the surgical team is eliminated, thereby reducing the
expense to the patient. Moreover, by eliminating the need for an assistant
directed by the surgeon,-the surgeon is able to proceed more quickly, which
results in further cost savings. Also, substantial benefits to the physical
wellbeing of the patient are achieved by the use of the retractor of the present
invention. The precise control that the surgeon has over the placement of and
tension applied to tne r~tracting devices minimize trauma during the course of
the operation.
- Furth~r modifications and alternative embodiments of the retractor
of this invention w;l~ be~-~pparent to those skilled in the art in view of this
descriptio~ ccordir.~y, this description is to be construed as illustrative only
and is ~or the purpose of teaching those skilled in the art the manner of carrying
out .he invention. It is ~o be understood that the forms of the invention herewith
shown and described ar~ to be taken as the presently preferred embodiments.
Various changes may ~e made in the shape, size and arrangement of parts. For
examplej equivalent elements or materials may be substituted for those
illustrated and described herein, parts may be reversed, and certain features of
the invention may be utili~ed independently of the use of other features, all as
would be apparent to one skilled in the art after havino the benefit of this
description of the invention.
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